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Alzheimer’s Caregivers List Wandering as a Top Concern

It happened in seconds. The phone rang while Maggie was carrying in the groceries with her mom, who has Alzheimer’s disease. By the time Maggie hung up on what proved to be a robocall, Mom was gone! Maggie was frantic. Luckily, she had alerted the neighbors that Mom was confused and tended to get lost. “Thank goodness,” she breathed as she spotted Mom coming down the sidewalk, assisted by a kind gentleman from the next block.

We see the sad stories on the news. An elderly person with dementia goes missing, and sometimes is found injured or worse. When these vulnerable elders wander away, they may be unable to ask for help or even tell who they are. It can be some time before the person is found, causing all manner of anguish for the family who are wracked with worry and with guilt because they weren’t 100 percent vigilant.

Fortunately, there is more awareness around this issue today. With more than five million Americans living with Alzheimer’s disease today, it’s a growing problem. We might receive a “Silver Alert” on our phone or TV urging us to be on the lookout for the missing elder. Police departments respond more quickly if they know a missing person has dementia. And new technologies help families keep tabs on their loved one.

Here is a three-part strategy to help families keep their loved one safe:

1. Understand why your loved one wanders.

When a person has Alzheimer’s disease, memory loss, confusion and disorientation make it increasingly difficult to recognize familiar faces and places, even one’s spouse, child, or a lifetime home. Other factors that contribute to wandering include restlessness, agitation and stress; boredom and lack of a sense of purpose; sleep disorders; physical pain; and sometimes the side effects of medications.

Geriatricians point out that the term “wandering” is something of a misnomer, because many times, in the person’s mind, the activity is not purposeless. They might be looking for the bathroom but be unable to find it. They might believe it’s time to leave for work, even though they retired years before. A great-grandmother might be searching for her own children, in the belief that they are still small and in need of her care. Wandering might be an expression of a desire to do something … just as the person has always done. In all likelihood, the person isn’t trying to “get away.” Instead, they are trying to get somewhere, though the place might be far away in location and time.

2. Take steps to reduce the risk.

Observe your loved one’s patterns. The first step is to understand as best you can the reason why the person with dementia is wandering. What are their “triggers”? Where do they usually try to go? During what time of day are they most restless? Do they seem to be looking for something, someone, or someplace?

Modify activities. Boredom and a sense of isolation often underlie wandering. Your loved one may enjoy appropriate art activities, crafts, household tasks, music, cooking simple foods and outings. Many communities now offer Alzheimer’s cafes, arts programs, and other modified activities for people with dementia. If your loved one is anxious in noisy places or where there are crowds, avoid shopping malls or other locations with lots of people, or go during off hours.

Keep doors locked. You can install special locks on doors, safety gates to prevent exit, and an alarm that will sound if the front door is open. The National Institute on Aging recommends using loosely fitted doorknob covers so that the cover turns instead of the actual knob. (To preserve an emergency exit, use these only when someone else is present in the home.) Check out other home safety modifications recommendations from the National Institute on Aging or the Alzheimer’s Association. These include devices to keep windows from opening all the way, adding visual cues to disguise the door, and a “stop” or “do not enter” sign on the door.

Be sure your loved one always carries ID, and a medical alert to tell others he has memory loss. If your loved one doesn’t consistently carry a wallet, try a bracelet, pendant, or clothing labels. Contact your local Alzheimer’s Association office to learn about their MedicAlert + Alzheimer’s Association Safe Return Program (see www.alz.org or call 1-888-572-8566 to find the program in your area). Some families these days also take advantage of GPS or other tracking technology to help locate loved ones quickly.

Notify neighbors and local merchants about your loved one’s condition. Show them a photo of your loved one. Ask them to contact you if they see your loved one out alone. Having this conversation with you makes it more likely that others will recognize the problem and feel comfortable getting involved. They will probably be glad to help, and relieved to be able to do so!

Hire home care. People with dementia are usually most comfortable in their own home rather than in a nursing home or other facility, but a person who wanders should not be left unattended. If your loved one requires more supervision than you and other family members can provide, it may be time to bring in home care services. Hire from an agency that trains its caregivers on the special needs of people with dementia. Trained caregivers provide supervision and care with a mind toward preserving the dignity and sense of well-being of clients with dementia. Regular physical exercise also reduces wandering; under the watchful supervision of the caregiver, your loved one can go on outings that decrease the anxiety and agitation. Care is also available at night.

Take care of yourself. Several studies have shown that when family caregivers feel stressed, depressed and overburdened, their loved one picks up on their depleted patience and emotional resilience, and is more likely to wander. Ask for help from friends and family and check out support resources in your area. Professional home care services not only keep clients safe, but also promote the well-being of the whole family. Families report that they have a more peaceful relationship with their loved one when a professional home caregiver takes over some personal care tasks.

3. Have a plan in place, just in case.

Even if you’ve taken all the precautions mentioned above, it’s prudent to anticipate that your loved one may nonetheless manage to wander away. Be prepared, and have a strategy at the ready:

The Alzheimer’s Association recommends that you search for your loved one in the immediate area for no longer than 15 minutes. If you haven’t found your loved one, call 9-1-1 and report that a vulnerable person with Alzheimer’s disease is missing. The association also recommends filing a report with their MedicAlert + Safe Return at 1-800-625-3780. First responders are trained to check with the Alzheimer’s Association Safe Return when they locate a missing person with dementia. You do not need to be enrolled in the program in order to file a missing report.

Find out if your state has a “Silver Alert” or equivalent program, similar to the “Amber Alert” for missing children. As law enforcement agencies recognize the needs of growing numbers of adults with dementia, more states are implementing this type of broadcast notification system.

Have a recent, close-up photo of your loved one available. You may be able to leave it on file ahead of need, along with your contact information, at the local police department. The National Institute on Aging also suggests that you keep an article of your loved one’s clothing in a plastic bag, worn and unwashed, in the event that the police department uses dogs for tracking.

Share your plan with your home care agency and anyone else who may be staying with your loved one while you aren’t there.